INTRODUCTION:

Chronic obstructive pulmonary disease (COPD) is prevalent disease affecting 6-8% of the population in India.^[1] According to the latest WHO estimates (2004), currently 64 million people have COPD and 3 million people died of COPD. WHO predicts that COPD will become the third leading cause of death worldwide by 2030.^[2}

A Correlation study on health-related quality of life with other disease severity indices in Indian chronic obstructive pulmonary disease patients sample size were 100 .the study results Patients with COPD showed significantly reduced HRQOL when measured by the World Health Organization’s QOL abbreviated questionnaire and the SGRQ. CLD estimate for severity of lung disease (P < 0.001), Medical Research Council assessment for dyspnea (P < 0.01), and duration of illness (P < 0.05) showed close correlation with HRQOL. Worsening forced expiratory volume in 1 second and 6-minute walk test results closely correlated with poorer HRQOL (P < 0.01). No association between QOL and age, quantum of smoking, education, co morbid illnesses, or occupational exposure was found. The study concluded that patients with COPD had reduced HRQOL. Longer disease duration, patient perception of disease severity, and worsening dyspnea impacted negatively on HRQOL ^[3]

Health related quality of life (HRQOL) refers to the degree to which the changes in health directly affect the domain of life including functional status (e.g. whether the patient is able to manage a household, use the telephone, or dress independently), emotional wellbeing, (e.g. depressive symptoms, positive affect) social engagement (involvement with others, engagement in activities) and symptom states (pain, shortness of breath, fatigue). ^[4]

A study conducted to evaluate the association between health related quality of life (HRQL) and disease severity using lung function method revealed that, the health related quality of life in COPD patients deteriorate with disease severity and with age. The data showed a relationship between health related quality of life and disease severity obtained by lung function. The deterioration is linearly related to a decrease in forced expiratory volume in 1 second (FEv₁%) predicted normal values. Chronic obstructive pulmonary disease is a major health problem affecting 8-10 percent of the adult population⁴ and it is thus well recognised that COPD is a source of significant disability in work life, family roles, satisfaction and functions of daily living, thereby leading to decreased health related quality of life (HRQL)^[5]

OBJECTIVES OF THE STUDY:

1.To assess the quality of life of chronic obstructive pulmonary disease patients.

2.To find out the association of quality of life of chronic obstructive pulmonary disease patients with their selected demographic variables.

METHOD AND MATERIAL:

Research design and approach:

Non-experimental, Descriptive cross-sectional survey approach.

Setting of the study:

Pravara Rural Hospital,Taluka Rahata, District Ahmednagar, Loni (Bk). Mahasrahstra.

Population:

Chronic Obstructive Pulmonary Disease patients admitted at Pravara Rural Hospital.

Sampling technique:

Non-probability purposive sampling technique was used for the selection of Chronic Obstructive Pulmonary Disease patients for the present study.

Sample size: 30 Chronic Obstructive Pulmonary Disease patients.

Inclusion criteria:

Patients who are:

1) Diagnosed to have Chronic Obstructive Pulmonary Disease

2) Age group above 35 years

3) Admitted in Medical Ward of Pravara Rural Hospital

4) Able to understand and read Marathi.

5). Willing to provide written informed consent.

Tool and technique:

Section A: Socio Demographic Profile of COPD, Clinical Characteristics of COPD

Section B: Quality of Life by St George’s Respiratory Questionnaire

Data collection procedure:

Formal permission was obtained from concerned authority Medical Superintendent, Head of Department of Medicine and Chest Physician of Pravara Rural Hospital, Loni (Bk), Maharashtra The study proposal was reviewed and approved by the Research Ethical Committee. Subjects was selected according to the selection criteria and assured the confidentiality of the sample. The instructions on the tool were made clear to facilitate the cooperation. The questionnaires were issued to the samples and instructed to fill it. Adequate time was provided to complete the questionnaires (45-60 min).The researcher helped the samples to understand the questions for obtaining the correct responses. Informed Written Consent was obtained after explaining the purpose of the study and assured the anonymity and confidentiality of information by the investigator.

Data analysis:

Descriptive statistics like mean, SD, mean percentage was used for description of demographic characteristics of Chronic obstructive pulmonary disease patient. Inferential statistics like chi-square test was used to find out the association of quality of life of COPD patients with demographic variables.

RESULTS AND DISCUSSION:

Section: A

Description of Demographic variables:

Majority of the subjects were in age group of 55-64 years (60%). Maximum (80%) subjects were males .Majority of the subjects were Hindus (93.33%). Highest percentage (66.70%) of the subjects were illiterate. Most of the subjects were farmers (40%) in study group. Regarding income most (53.3%) of the subjects earned between below 3000/-per month.

Clinical Characteristics of COPD patients:

Majority (93.33%) of the subjects were passive smokers. Maximum (33.3%) females were exposed to biomass fuel. Highest (40%) of the subjects smoke above one packet per day Maximum (53.4%) had allergy due to dust. Majority (46.7%) of the subjects had exposure to allergens above 5 years. Most of the subjects 4(26.7%) had duration of illness below one year. Majority 100% of the subjects did not suffer from co-morbid illness .Maximum (46.6%) had regular treatment.

Section: B Assess the quality of life of Chronic Obstructive Pulmonary Disease patients

Quality of Life	Mean	Standard deviation	Range
SGRQ	56.46	15.28	0-93
Symptoms	69.22	15.74	0-100
Impacts	50 33	14.15	0-92
Total	55.66	13.01	0-88

SGRQ, St George’s Respiratory Questionnaire.

Table 1 shows, the mean total score of SGRQ in the COPD patients was 55.66±13.01, The SGRQ scores showed significant impairment in all three domain measures, symptoms, activity and impacts.

Section: CAssociation of quality of life with selected demographic variables:

No significant association found in study group in respect of demographic characteristics (p>0.05) By applying Chi-Square test there is a significant association between demographic characteristics namely; History of exposure to smoke, Duration of exposure to pollutants, Duration of Illness in Study group (p<0.05) and remaining characteristics are not significant (p>0.05)

DISCUSSION:

The study showed impaired quality of life of COPD patients. In the present study there is a significant association between demographic characteristics namely; History of exposure to smoke, Duration of exposure to pollutants, Duration of Illness in Study group (p<0.05) and remaining characteristics are not significant (p>0.05). Research in the area of quality of life a fundamental foundation for the promotion of best practice. In the previous studies, older age, presence of co morbid illness, less education and greater smoking consumption related to lower QOL.[6]-[10].

CONCLUSION:

COPD is an incurable slowly progressive chronic illness concentrating therapy on selected treatable aspects of QOL may result in more effective care. Also in view of the increased prevalence of biomass fuel for cooking in Indian households, studies need to concluded to assess the effects on women and their QOL.

REFERENCES:

1. Bethsda MD.Natinal Heart,Lung and Blood Institute.Global Initiative for Chronic Obstructive Lung Disease. March 2110(updated 2003)NIH publication 2701A. Available at: http://www.goldcopd.org. Accessed February 2, 2012.

2. Murray CJ, Lopez AD. Evidence based health policy-lessons from the Global Burden of Disease Study. Science.1996:274(5288);740-743.

3. Murthy KJR, Sastry JG. Economic burden of chronic obstructive pulmonary disease. [online2011].[cited2011May11];Availablefrom:URL:http://whoindia.org/Economic_burden_of_chronic_obstructive_pulmonary_disease.

4. Shavro SA,Ezhlarasu P, Anqustine J, Bechtel JJ, Christopher DJ.correlation of health-related quality of life with other disease severity indices on Indian chronic obstructive pulmonary disease patients.int J chronic. Obstructive pulmonary disease 2012; 7: 291-6 .

5. Quality of life, definition and measurement. Available from: URL:www.novelguide.com/a/discover/eoa ./eoa_04_00344.html. Accessed August 11, 2010.

6. Stahl E, Lind Berg A, Jansson SA, Ronmark E, Svensson K, Andersson F. COPD disease severity. Health quality of life outcomes 2005 Sep; 9 (3): 56.

7. Ferrer M, Alonso J, Morea J, et al. Chroninc obstructive pulmonary disease stage and health related quality of life: the Quality of life of chronic obstructive pulmonary disease study group. Ann Intern Med 1997; 127 (12):1072-1079.

8. Prigtonao GP, Wriht EC, Levin D. qulaity of life and its predictors in patients with mild hypoxemia and chronic obstructive pulmonary disease. Arch Inern med 2001; 144: 1613-16-19.

9. Wijnhoven AH, Kreigman MW, Hesselin AE, Pennix WJ de Hann M determinnts of different dimensions of disease severity in asthma dnCOPD- pulmonary function an dhealth related qulaity of life. Chest. 2001; 1, 19 (4): 1034-1042.

10. Anderson KL. The effect of chronic obstructive pulmonary disease . Res Nurs Health.1995; 18:547-556.

Received on 10.08.2017 Modified on 18.09.2017

Asian J. Nursing Education and Research. 2018; 8(1): 43-45.

DOI: 10.5958/2349-2996.2018.00010.1